The Best American Science and Nature Writing 2013 by Siddhartha Mukherjee

Author:Siddhartha Mukherjee
Language: eng
Format: epub
Publisher: Houghton Mifflin Harcourt

Astrid Joosten wasn’t the only person in recent years to die of Marburg. In 2007, a year before her visit to Uganda, a small outbreak occurred among miners in roughly the same area. Just four men were affected, of whom one died. All of them worked at a site called Kitaka Cave, in the southwestern corner of Uganda.

Soon after the news of the affliction got out, in August 2007, an international response team converged on Uganda to assist and collaborate with the Ugandan Ministry of Health. The group included scientists from the Centers for Disease Control and Prevention (CDC) in Atlanta, the National Institute for Communicable Diseases (NICD) in South Africa, and the World Health Organization (WHO) in Geneva. From the CDC there was Pierre Rollin, an expert on the filoviruses and their clinical impacts. Along with him from Atlanta had come Jonathan Towner, Brian Amman, and Serena Carroll. Pierre Formenty had arrived from the WHO; Bob Swanepoel and Alan Kemp of the NICD had flown up from Johannesburg. All of them possessed extensive experience with Ebola and Marburg, gained variously through outbreak responses, lab research, and field studies.

The cave served as the roosting site for about 100,000 individuals of the Egyptian fruit bat, then a prime suspect as a reservoir for Marburg. The team members, wearing Tyvek suits, rubber boots, goggles, respirators, gloves, and helmets, had been shown to the shaft by miners, who as usual were clad only in shorts, T-shirts, and sandals. Guano covered the ground. The miners clapped their hands to scatter low-hanging bats as they went. The bats, panicked, came streaming out. These were sizable animals, each with a two-foot wingspan, not quite so large and hefty as some fruit bats but still daunting, especially with thousands swooshing at you in a narrow tunnel. Before he knew it, Amman had been conked in the face by a bat and taken a cut over one eyebrow. Towner got hit too. Fruit bats have long, sharp thumbnails. Later, because of the cut, Amman would get a postexposure shot against rabies, though Marburg was a more immediate concern. “Yeah,” he thought, “this could be a really good place for transmission.”

The cave had several shafts. The main shaft was about eight feet high. Because of all the mining activity, many of the bats had shifted their roosting preference “and went over to what we called the cobra shaft,” Amman later told me. The shaft was so called because, he said, “there was a black forest cobra in there.”

Or maybe a couple. It was a good dark habitat for a snake, with water and plenty of bats to eat. The miners showed Amman and Towner into the cave and led them to a chamber containing a body of brown, tepid water. Then the local fellows cleared out, leaving the scientists to explore on their own. They dropped down beside the brown lake and found that the chamber branched into three shafts, each of which seemed blocked by standing water. Peering into those shafts, they could see many more bats.

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